Up until now we had all been using the same definitions for sepsis, severe sepsis and septic shock. CMS has tweaked these familiar definitions a bit (with a bit of controversy) and require we do and document several things.

Several years ago I spent a couple of hours with our head coder to come up with a macro that would make us “compliant” with all the “points” that billers care about. I don’t remember what “points” are, but I know that when I use this macro I get a lot of RVU’s out of each chart. It’s also helpful for a quick summary at the end. Continue reading “Maximizing Charting Points”→

Chest pain is one of the more common presenting complaints to our Emergency Department. We daily tease out those who require further testing for acute coronary syndromes vs those who can be safely discharged home. If we approaching these patients in a consistent way, we can hopefully create a consistent and safe process for evaluating these patients. I propose the HEART score. Unlike the other scores (PURSUIT, TIMI, GRACE, FRISC), HEART performs well and was tested in the ED. Continue reading “Low Risk Chest Pain (HEART score)”→

Here is a suicide checklist I created after listening to Rob Orman’s ER CAST. He reviewed the literature, and while there is no checklist that can predict anyone’s behavior, this seemed like a good list of things to document in those who are potentially at risk for suicide.